EBQ:Sodium Bicarbonate use in DKA: Difference between revisions
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===Trial 1=== | ===Trial 1=== | ||
'''21 patients''' underwent RCT | '''21 patients''' underwent RCT | ||
* 10 patients (PH 6.9-7.14)received NaHco<sub>3</sub> | * 10 patients (PH 6.9-7.14) received NaHco<sub>3</sub> | ||
* 11 patients in the control group | * 11 patients in the control group | ||
'''Results:''' No differences in Glucose level, bicarb level nor PH <ref>Ann Intern Med. 1986 Dec;105(6):836-40</ref> | '''Results:''' No differences in Glucose level, bicarb level nor PH <ref>Ann Intern Med. 1986 Dec;105(6):836-40</ref> | ||
Revision as of 13:06, 15 April 2014
Clinical Question
Should Sodium Bicarbonate be used to treat Diabetic Ketoacidosis ?
Background
Sodium bicarbonate is a solution which help alkalanizing the blood by binding the H+ and converting it to water and Co2. Many Physicians use it to treat DKA, but based on what ? Is there any evidence supporting its use ?
Pro Argument
Trial 1
Trial 2
Trial 3
Con Argument
Trial 1
21 patients underwent RCT
- 10 patients (PH 6.9-7.14) received NaHco3
- 11 patients in the control group
Results: No differences in Glucose level, bicarb level nor PH [1]
Trial 2
Prospective, Randomized, Blinded and cross over study included 14 patients
- HCO3 level <17
- Received Sodium Bicarbonate 2mmol/kg over 15 minutes
Results: Sodium Bicarbonate decreased Ionized Calcium, increased Paco2 and didn't improve hemodynamics[2]
Trial 3
Review Article included patients with PH<7
- Results: Sodium Bicarbonate didn't improve time to improvement not to hospital discharge[3]
Sources
http://saudiemergencymedicine.com/should-you-use-sodium-bicarbonate-in-acidosis-stop-for-a-minute/